Correlation of Clinical and Endoscopic Evaluation with PET-CT in Detecting Recurrence of Head and Neck Squamous Cell Carcinoma

Main Article Content

Rambabu Mappuri
Ramakrishnan Narayanaswamy

Abstract

Introduction


The current study reports the correlation of clinical and endoscopic evaluation with 18F-Fluorine Fluorodeoxyglucose Positron emission tomography/Computed tomography (18F-FDG PET/CT) findings in detecting the residual/recurrence tumor after definitive treatment in the follow up cases of squamous cell carcinoma head and neck.


Materials and Methods


A prospective comparative study carried out on 30 follow-up cancer patients after definitive primary treatment. All patients were evaluated by clinical examination, endoscopy and 18F-FDG PET/CT and these results correlated to detect residual/recurrence. Suspicious lesion at primary site suggesting residual/recurrence was confirmed by gold standard investigation, histopathological examination (HPE).  


Result


The age group mostly involved is 40-70 with male predominance. Predominant sites were oral cavity and larynx. 20 patients showed recurrence on clinical and endoscopic evaluation with 03 false positive results, 10 patients showed no recurrence with 01 false negative result. On PET/CT, 19 patients were showed recurrence with 01 false positive result, 11 patients showed no recurrence. PET/CT showed high sensitivity, specificity, with high NPV in detecting the recurrence of disease in the follow up period. Clinical and endoscopic evaluation also has high sensitivity, PPV and NPV.


Conclusion


It is recommended that 18F-FDG PET/CT scan should be done in every case after primary treatment in addition to complete clinical and endoscopic evaluation and during follow-up period for early detection and management of residual/ recurrence.

Article Details

How to Cite
1.
Mappuri R, Narayanaswamy R. Correlation of Clinical and Endoscopic Evaluation with PET-CT in Detecting Recurrence of Head and Neck Squamous Cell Carcinoma. BJOHNS [Internet]. 2020Jul.27 [cited 2024May18];26(2):105-11. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/168
Section
Main article

References

Abouzied MM, Fathala A, AI Muhaideb AI, AI Qahtani MH, Role of fluorodeoxyglucose-positron emission tomography in the evaluation of head and neck carcinoma. World J Nucl Med. 2017; 16:257-65

Cacicedo J, Navarro A, Del Hoyo O, Gomez-Iturriaga A, Alongi F, Medina JA, et al. Role of fluorine-18 fluorodeoxyglucose PET/CT in head and neck oncology: the point of view of the radiation oncologist. Br J Radiol. 2016; 89: 20160-217

Proia NK, Prszkiewicz GM, Nasca MA, Franke GE, Pauly JL. Smoking and smokeless tobacco-associated human buccal cell mutations and their association with oral cancer –a review. Epidemiol Biomarker Prev. 2006; 15: 1061-77

Hannah A, Scott AM, Tochon-Danguy H et al. Evaluation of 18F-FDG PET/CT with Histopathological correlation in the initial staging of head and neck cancer. Ann Surg. 2002; 236: 208-17

Ryan WR, Fee WE Jr, Le QT, et al. Positron-emission tomography for surveillance of head and neck cancer. Laryngoscope 2005; 115:645-50

Nelissen C, Sherriff J, Jones T, Guest P et al., The Role of Positron Emission Tomography/Computed Tomography Imaging in Head and Neck Cancer after Radical Chemoradiotherapy. Clin Oncol.(R Col Radiol.) 2017; 29 (11): 753-9

Bundhit T, Yu F, Kanard A, Miller F R. Role of 18-FDG PET/CT in pre and post treatment evaluation in head and neck carcinoma. World J Radiol. 2014;6(5):177-91

Abgral R, Querellou S, Potard G, Le Duc-Pennec A, Marianovski R, et al. Does 18F-FDG PET/CT improve the detection of post treatment recurrence of head and neck squamous cell carcinoma in patients negative for disease on clinical follow-up? J Nucl Med. 2009;50:24-9

Zundel MT, Michel MA, Schultz CJ, Maheshwari M, Wong SJ, Campbell BH, et al. Comparison of physical examination and fluorodeoxyglucose positron emission tomography/computed tomography 4– 6 months after radiotherapy to assess residual head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2011; 81: e825–32

Slevin F, Subesinghe M, Ramasamy S, Sen M, Scarsbrook AF, Prestwich RJ. Assessment of outcomes with delayed (18)F-FDG PET-CT response assessment in head and neck squamous cell carcinoma. Br J Radiol. 2015; 88(1052):20140592

Wang YF, Liu RS, Chu PY, Chang FC, Tai SK, Tsai TL, et al. Positron emission tomography in surveillance of head and neck squamous cell carcinoma after de- finitive chemoradiotherapy. Head Neck 2009; 31: 442–51

Gupta T, Master Z, Kannan S, Agarwal JP et al. Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2011; 38(11):2083-95.